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Vitamin D Levels in the Pre- and Post-COVID-19 Pandemic Periods and Related Confinement at Pediatric Age
Caterina Mosca1, Angelo Colucci2, Fabio Savoia3
1Department of Translational Medical Science, Section of Pediatrics, University Federico II, 80131 Naples, Italy.
Insights
COVID-19 lockdowns increased vitamin D deficiency in children, especially males and those aged 1-12. This highlights the need for supplementation during confinement periods to maintain adequate vitamin D levels.
Area of Science:
- Pediatrics
- Endocrinology
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) restrictions have been linked to vitamin D deficiency in children.
- Previous studies show mixed results regarding the impact of lockdowns on vitamin D levels.
Purpose of the Study:
- To investigate the effect of COVID-19 lockdown on vitamin 25-(OH) D blood levels in Italian children and adolescents with chronic diseases.
- To identify risk factors for vitamin D deficiency during the lockdown period.
Main Methods:
- Retrospective study of 2182 Italian children/adolescents hospitalized before (n=1052) and during (n=1130) the COVID-19 lockdown.
- Analysis of vitamin 25-(OH) D blood levels, comparing deficiency status and seasonal variations between the two periods.
- Statistical analysis to identify risk factors, including age, gender, and underlying disease.
Main Results:
- While mean vitamin D levels remained similar, the prevalence of deficiency significantly increased during the lockdown (p=0.03), particularly in summer (p=0.02).
- Males (OR=1.22), and children aged 1-5 (OR=1.57) and 6-12 (OR=1.30) years were at higher risk.
- Infants were not affected. In the post-COVID period, deficiency risk was unchanged overall but differed in specific subgroups: higher in endocrinopathy, lower in respiratory problems and obesity.
Conclusions:
- COVID-19 lockdown restrictions exacerbated vitamin D deficiency in hospitalized children, especially in specific age groups and males.
- The findings suggest a need for targeted vitamin D supplementation strategies during future confinement periods.
- Further research is warranted to clarify supplementation needs amidst conflicting literature and varying impacts across disease subgroups.
Abstract:
Coronavirus disease 2019 (COVID-19) restrictions have been correlated with vitamin D deficiency in children, but some uncertainties remain. We retrospectively studied vitamin 25-(OH) D blood levels in 2182 Italian children/adolescents hospitalized for various chronic diseases in the year before (n = 1052) and after (n = 1130) the nationwide lockdown. The type of underlying disease, gender, and mean age (91 ± 55 and 91 ± 61 months, respectively) of patients included in the two periods were comparable. Although mean levels were the same (p = 0.24), deficiency status affected a significantly higher number of subjects during the lockdown period than in the pre-COVID period (p = 0.03), particularly in summer (p = 0.02), and there was also a smoothing of seasonal variations in vitamin D levels. Particularly at risk were males (OR = 1.22; p = 0.03), the 1-5 year age group (OR = 1.57; p < 0.01) and the 6-12 year age group (OR = 1.30; p = 0.04). Infants appeared not to be affected (p = 1.00). In the post-COVID period, the risk of vitamin D deficiency was unchanged in disease-specific groups. However, the proportion of deficiency or severe deficiency differed significantly in the subgroup with endocrinopathy (higher; Chi-square p = 0.04), and with respiratory problems and obesity (lower; Chi-square p = 0.01 and p < 0.01, respectively). Conflicting/opposite literature results advocate for further studies to clearly indicate the need for supplementation during possible future periods of confinement.
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